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"Not Alms, But a Right": Slaps 2-Month Deadline on Medical Bill Reimbursements
In a landmark ruling that could ease the plight of countless government employees, the has declared medical reimbursement a , not charity. Justice Sudeeppti Sharma dismissed the 's second appeal, upholding a widow's decree for full reimbursement plus interest after a grueling 15-year battle. The court went further, mandating states and public bodies to process claims within two months —or pay 9% interest for delays.
From Accident to Endless Red Tape: Savita Yadav's Ordeal
Savita Yadav's husband, Yadu Yadav, suffered a severe head injury in a motor accident on , near Jhajjar. Rushed from Rewari's Trauma Center to Gurugram's Kalyani Hospital, then Paras Hospital—due to no ventilators—he underwent treatment until , costing Rs. 7,54,975 (net Rs. 6,00,031 after subsidy). Subsequent incidents in —a tibia fracture treated at Delhi's Sir Ganga Ram Hospital (Rs. 1,40,975) and a slipped VP shunt at Paras again (Rs. 68,989.73)—piled on expenses.
Yadav submitted claims promptly in , backed by bills, emergency certificates from Civil Surgeon Rewari and others. Yet, Haryana's bureaucracy shuffled files for a year, partially paid at PGI rates + 75% for unapproved hospitals, withheld balances (Rs. 3,03,712; Rs. 91,996; Rs. 41,984), and ignored full entitlements for approved facilities like Sir Ganga Ram. Lower courts in Rewari decreed her suit in ; the High Court appeal lingered until .
State's Defiance vs. Widow's Plea: The Clash in Court
Haryana argued no emergency certificates justified full claims, citing Om Prakash Gargi v. State of Punjab (1996) to block 12% interest on delays. They claimed PGI-rate payments sufficed, insisting unapproved private hospitals barred higher reimbursements.
Yadav countered with undisputed bills, partial payments proving genuineness, and emergency realities—patients can't "hunt" approved lists mid-crisis. She invoked P&H precedents stressing for employee welfare, demanding full amounts at policy rates plus 12% interest from submission dates for arbitrary delays.
"Human Life at Stake": Court's Sharp Legal Dissection
Justice Sharma meticulously parsed the record: bills genuine, emergencies certified, approved hospitals like Sir Ganga Ram entitled to full pay, unapproved ones to PGI + 75%. She distinguished Om Prakash —there, claims needed verification; here, courts already vetted via evidence.
Drawing from
State of Punjab v. Bhupinder Singh
(),
Santosh Devi v. Haryana State Agricultural Marketing Board
(2008),
Raghuvir Prasad Mittal v.
(2008), and
Naunihal Singh v. Union of India
(2011), the court emphasized
's right to life.
"Treatment is a matter of confidence between patient and doctor,"
it noted, rejecting "wooden attitudes" on technicalities. Delays—files ping-ponged for a year, suit stayed 11 years—defeat reimbursement's purpose.
Echoing media reports, the judgment laments: after 19 years in similar cases,
"This is the state of affairs of Government employee who is assured reimbursement."
Key Observations
"Medical reimbursement is a right of a government employee, which is part of the benefits granted by the government to an employee. It is a of an employee which should be granted within a reasonable period of submission of medical reimbursement bills."
"Once an employee is entitled to any benefit which is not granted to him within a reasonable period, it should be granted with interest. Otherwise, the department would not be releasing the benefit for years together."
"In a case where the life of a human being is at stake, it is too technical to require such a person to hunt for a list of the approved hospitals and then decide which hospital to go in emergency situation."
"The act committed in an emergency should not be weighed in terms of money, especially when human life is at stake."
Victory with a Broader Whip: Directive to States
The court upheld Rewari courts' decrees, dismissing the appeal. In , it fixed a maximum two-month processing timeline for medical claims by Punjab, Haryana, Chandigarh, their corporations, and boards— 9% interest beyond that.
This binds authorities immediately (copy forwarded), promising swifter relief and deterring delays. For Yadav, it ends a 16-year wait; for employees, it fortifies welfare against bureaucratic inertia.
